Provider Demographics
NPI:1760040786
Name:HAMPTON, KRISTINA LYNN (BA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:LYNN
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 W OAK CT
Mailing Address - Street 2:
Mailing Address - City:LANESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47136-9471
Mailing Address - Country:US
Mailing Address - Phone:502-609-5287
Mailing Address - Fax:
Practice Address - Street 1:3000 W OAK CT
Practice Address - Street 2:
Practice Address - City:LANESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47136-9471
Practice Address - Country:US
Practice Address - Phone:502-609-5287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist